Effect of laser on pain relief and wound healing of recurrent aphthous stomatitis: a systematic review
- 1.1k Downloads
The aim of this systematic review was to assess a potential benefit of laser use in the treatment of recurrent aphthous stomatitis (RAS). The primary outcome variables were pain relief, duration of wound healing and reduction in episode frequency. A PICO approach was used as a search strategy in Medline, Embase and Cochrane databases. After scanning and excluding titles, abstracts and full texts, 11 studies (ten RCTs and one non-randomised controlled trial) were included. Study selection and data extraction was done by two observers. Study participants varied between 7–90 for the laser and 5–90 for the control groups. Laser treatment included Nd:YAG laser ablation, CO2 laser applied through a transparent gel (non-ablative) and diode laser in a low-level laser treatment (LLLT) mode. Control groups had placebo, no therapy or topical corticosteroid treatment. Significant pain relief immediately after treatment was found in five out of six studies. Pain relief in the days following treatment was recorded in seven studies. The duration of RAS wound healing was also reduced in five studies. However, criteria of evaluation differed between the studies. The episode frequency was not evaluated as only one study addressed this outcome parameter, but did not discriminate between the study (LLLT) and control (corticosteroid) groups. Jadad scores (ranging from 0 to 5) for quality assessment of the included studies range between 0 and 2 (mean = 1.0) for studies analysing pain relief and between 0 and 3 (mean = 1.1) for studies evaluating wound healing. The use of lasers (CO2 laser, Nd:YAG laser and diode laser) to relieve symptoms and promote healing of RAS is a therapeutic option. More studies for laser applications are necessary to demonstrate superiority over topical pharmaceutical treatment and to recommend a specific laser type, wavelength, power output and applied energy (ablative versus photobiomodulation).
KeywordsAphthous ulcer CO2 laser Diode laser Nd:YAG laser Low-level laser Photobiostimulation Photobiomodulation
Compliance with ethical standards
Conflict of interest
The authors declare no conflict of interest.
The study was funded by departmental funds of the Department of Oral Surgery and Stomatology, University of Bern.
Ethical approval was not needed for this systematic review.
Informed consent was not needed for this systematic review.
- 4.Davatchi F, Tehrani-Banihashemi A, Jamshidi AR, Chams-Davatchi C, Gholami J, Moradi M, Akhlaghi M, Foroozanfar MH, Barghamdi M, Noorolahzadeh E, Samadi F, Hadj-Aliloo M, Ghaznavi K, Ghaznavi K, Soroosh M, Khabazi A, Salari AH, Sharif SK, Karimifar M, Salessi M, Essalat-Manesh K, Nadji A, Shahram F (2008) The prevalence of oral aphthosis in a normal population in Iran: a WHO-ILAR COPCORD study. Arch Iran Med 11:207–209PubMedGoogle Scholar
- 16.Taylor J, Glenny AM, Walsh T, Brocklehurst P, Riley P, Gorodkin R, Pemberton MN (2014) Interventions for the management of oral ulcers in Behçet’s disease. Cochrane Database Syst Rev 9:CD011018Google Scholar
- 18.Brocklehurst P, Tickle M, Glenny AM, Lewis MA, Pemberton MN, Taylor J, Walsh T, Riley P, Yates JM (2012) Systemic interventions for recurrent aphthous stomatitis (mouth ulcers). Cochrane Database Syst Rev 9:CD005411Google Scholar
- 27.Salman H, Kashmoola MA, Al-Waiz MM, Al-Sandooq TA (2008) Differences between low level laser therapy and triamcinolone acetonide kenalog on healing of recurrent aphthous ulceration. Ann Coll Med 34:35–41Google Scholar
- 28.Hazeem MI, Rajab MS, Badeia RA (2013) Treatment of recurrent aphthous stomatitis with 940 nm diode laser. Tikrit J Dental Sci 1:77–82Google Scholar
- 36.NAALT (2017) https://www.naalt.org/index.php/whitepapers/25-nomenclature-whitepaper. Last accessed 8 February 2017